Watanabe Shadow Mountain Dental Group, Professional Corporation

NPI #1427238534 in Las Vegas, Nevada

Provider Information

NPI Number: 1427238534
Entity Type: Organization
Organization Name: Watanabe Shadow Mountain Dental Group, Professional Corporation
Primary Specialty: Dentist - General Practice
Enumeration Date: Nov 6, 2007
Last Updated: Nov 7, 2007

Practice Location

Address: 6525 N DECATUR BLVD
Address 2: SUITE 150
City: Las Vegas
State: Nevada
ZIP Code: 89131
Phone: (702) 577-1941

Authorized Official

Name: DR. LYNDA C WATANABE, DDS
Title: OWNER DOCTOR
Phone: (702) 577-1941

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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